Objective:To compare the effect of laparoscopic uterine isthmus cerclage and transvaginal uterine isthmus cerclage in the treatment of cervical incompetence at non pregnant condition.Methods:A total of 63 patients with cervical incompetence from May 2013 to May 2015 in our hospital were enrolled in the retrospective analysis,all the enrolled patients had naturally conceived single birth with complete data after laparoscopic uterine isthmus cerclage or transvaginal uterine isthmus cerclage and were divided into two groups according to two different surgical methods for uterine isthmus cerclage to compare the clinical effect.30 patients treated with laparoscopic uterine isthmus cerclage were,in the research group and the other 33 patients treated with transvaginal uterine isthmus cerclage were in the control group.Results:The treatment success rate of research group (96.67％) was significantly higher than that of the control group(51.52％) (P ＜ 0.05).The research group had got a longer average pregnancy period than control group (P ＜ 0.05).Postoperative abortion rate (3.33％) and preterm birth rate(10.00％) of research group were obviously lower than the control group (48.48％,30.30％)(P＜0.05).The term infant rate of research group (86.67％) was higher than control group (21.21％) (P ＜0.05).The operation time((37.27 ± 1.93 min) and hospital stay(5.17 ±0.38 d) of the research group were less than the control group(P＜0.05).The bleeding amount in surgery of research group(13.13 ±1.57ml) was significantly lower than the control group(31.61 ± 1.87 ml) (P ＜ 0.05).The complication rate of observation group was 0,and the control group was 18.18％.The difference was significant(P ＜ 0.05).Conclusions:Laparoscopic uterine isthmus cerclage in treatment of cervical imcompetence at non pregnant condition has better clinical effect than transvaginal uterine isthmus cerclage.It has higher security and feasibility.It is worth clinically promoting.

Objective:To investigate the ultrasonographic characteristics and risk factors of breast cancer internal mammary lymph node (IMLN) metastasis.Methods:A retrospective analysis of 296 first diagnosed breast cancer patients in the Fourth Hospital of Hebei Medical University from March 2010 to May 2020. IMLN was divided into metastatic group (236 cases) and non-metastatic group (60 cases) based on pathology. Chi-square test and independent sample t test were used to analyze the ultrasound characteristics of IMLN metastasis and factors related to metastasis. ROC curve analysis of IMLNs were plotted to obtain the diagnostic thresholds and their sensitivity and specificity.Univariate and multivariate Logistic analysis was used to analyze the risk factors of IMLN metastasis. Results:①The appearances of IMLN in ultrasound were normal type, thickened-cortex type, unclear hilus structure type and thickened-nodular soft tissue type. ②In the two groups, the differences in IMLN long diameter, thickness diameter, number, and lymphatic hilum structure type were statistically significant (all P<0.05), and there were no significant differences in IMLN long diameter/thickness diameter and IMLN blood supply (all P>0.05). ③The long diameter threshold of IMLN for diagnosis of metastasis was 10.5 mm, the are under the ROC curve(AUC) was 0.825, with sensitivity of 58.5% and specificity 93.3%; thickness and diameter threshold was 4.5 mm, AUC was 0.790, with sensitivity 66.9% and specificity 75.0%. The sensitivity and specificity of the diagnosis of long-diameter combined structure type were 56.3% and 93.3%, respectively; the sensitivity and specificity of the diagnosis of thick-diameter combined structure type were 64.8% and 81.7%, respectively. The cortical thickness threshold was 1.9 mm, and the diagnostic sensitivity and specificity were 91.9% and 86.7%, respectively. ④The risk factors of IMLN metastasis inculded univariate analysis showed tumor length, tumor volume, axillary lymph node long diameter, axillary lymph node metastasis, and clavicle lymph node metastasis. There was a statistically significant difference in the pathology of the lower lymph nodes between the two groups ( P<0.05). Multivariate analysis showed that the long diameter of the tumor and the metastasis of the axillary lymph nodes were independent risk factors of IMLN metastasis. Conclusions:The metastatic IMLN mostly manifest as no lymphatic hilum structure or cortical thickening (≥1.9 mm), and multiple IMLN can help diagnose metastasis.Ultrasound can better assess breast cancer IMLN metastasis, and the diagnostic efficiency of IMLN long-diameter combines structure type is higher.Independent risk factors for IMLN metastasis include tumor size and axillary lymph node metastasis.

Objective To investigate the effect of expression of microRNA-27a(miR-27a) and microRNA-451(miR-451) in A2780/T cells and its relativity to multidrug resistance (MDR)1 mRNA inhibition by procyanidin. Methods Stem-loop PCR method was performed to evaluate the expression of miR-27a and miR-451 in use of procyanidin (0-40μmol/L) in 0-48 h in A2780/T cells. Additionally, over-expressing or interfecting microRNAs by using mimics or inhibitor of miR-27a and miR-451, the expression of MDR1 mRNA was assessed by RT-PCR in cells exposing to procyanidin. Results The expression of miR-27a and miR-451 was significant inhibited by procyanidin in both time- and concentration-dependency. Over-expressed MDR1 mRNA associated with miR-27a or miR-451 mimics was blocked by procyanidin, whereas there was no effect on down-expressed MDR1 mRNA associated with miR-27a or miR-451 inhibitor by procyanidin. Conclusion Procyanidin inhibits MDR1 mRNA expression by inhibiting miR-27a and miR-451 expression in A2780/T cells.

The association of non-HDL-cholesterol and non-HDL-C-to-HDL-cholesterol ratio (non-HDL-C-to-HDL-C ratio) with early diabetic nephropathy in patients with type 2 diabetes mellitus was investigated.Non-HDL-C and non-HDL-C-to-HDL-C ratio were positively related with microalbuminuria (P＜0.05 or P＜0.01).Non-HDL-C-to-HDL-C ratio is an independent risk factor of early diabetic nephropathy in patients with type 2 diabetes mellitus.

ObjectiveTo explore the effects of hyperbaric oxygen (HBO) on severe brain injury. Methods60 patients with severe brain injury were divided into control group and treatment group. They were treated with neurosurgical conventional therapy, and HBO for treatment group in addition. They were assessed with Glasgow Coma Scale (GCS) before and after treatment, and Glasgow Outcome Scale (GOS) 3 and 6 months after treatment. ResultsCompared with control group, there is significant improvement in GCS (P<0.05) and GOS (P<0.05) in treatment group. ConclusionHBO has immediate and long-term efficiency on severe brain injury.

Objective:To compare and study the clinical efficacy of three different phacoemulsification incisions for cataract patients with type 2 diabetes mellitus.Methods:A retrospective analysis was performed in 120 patients (198 eyes) with type 2 diabetes cataract who underwent cataract extraction and intraocular lens implantation from January 2018 to June 2019 in the First hospital of Hebei Medical University. According to the surgical incision, the patients were divided into three groups: A group (the cornea scleral marginal incision, 40 cases, 72 eyes), B group (the clear corneal incision at the top , 40 cases, 66 eyes), C group (underwent temporal clear corneal incision, 40 cases, 60 eyes). The corneal perception, dry eye symptoms, basic tear secretion test (SIt), tear film rupture time (BUT), corneal fluorescein staining (FL) and complications were compared among the three groups before and after treatment.Results:The corneal perception of B group and C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05); The scores of dry eye symptoms in C group were higher than those in A group and B group on 1 d, 7 d and 30 d after operation ( P<0.05), and the scores of dry eye symptoms in B group were higher than those in A group on 1 d and 7 d after operation ( P<0.05); The SIt value of C group was lower than that of A group on 1 d, 7 d and 30 d after operation ( P<0.05), and that of B group was lower than that of A group and group C on 1 d, 7 d and 30 d after operation ( P<0.05); The BUT value of C group was lower than that of A group at 1 d and 7 d after operation ( P<0.05), and the BUT value of B group was lower than that of A group and C group at 1 d, 7 d and 30 d after operation ( P<0.05); The FL value between A group and C group at 1 d, 7 d, 30 d and 90 d after treatment was not significant ( P>0.05). The FL value of B group returned to the level before treatment at 30 d after operation, and the FL value of B group was higher than that of A group and C group at 1 d and 7 d after operation ( P<0.05); There was little difference in the incidence of complications among the three groups ( P>0.05). Conclusions:The cornea scleral marginal incision can reduce the tear secretion, maintain the stability of tear film, and is more suitable for cataract patients with type 2 diabetes mellitus. It is worthy of further promotion in clinic.

Extracorporeal membrane oxygenation (ECMO) is a technique in which breathing and circulation are supported extracorporeally. Severe trauma may induce cardiopulmonary failure, for which ECMO can play an adjunctive role in the salvage treatment of circulatory and respiratory failure when conventional treatments are ineffective. Bypass with ECMO can rapidly improve the state such as circulatory failure and hypoxemia in critically ill patients in short term and can partially or fully replace their cardiopulmonary function in long term, winning valuable time for normal recovery of cardiopulmonary function. Because of the physical state of severe trauma patients and the ECMO equipment, there are still various complications clinically. Trauma patients show high risk of bleeding, vulnerability to wound infection and probability of combined organ injury and dysfunction, so more comprehensive measures for the prevention and treatment of complications during the use of ECMO therapy are required. The authors review the research progress in complications and corresponding prevention and treatment strategies during ECMO support for severe trauma, aiming to provide a reference to prevent and treat these complications.

Objective:To explore the effect of phacoemulsification through corneoscleral incision on cataract patients with type 2 diabetes mellitus.Methods:A prospective case-control study was conducted to collect cataract patients with type 2 diabetes who were admitted to the First Hospital of Hebei Medical University from January 2018 to June 2019. All patients were treated with phacoemulsification. They were randomly divided into three groups: 40 cases (68 eyes) of corneoscleral incision, 40 cases (66 eyes) of upper transparent corneal incision and 40 cases (70 eyes) of temporal transparent corneal incision. The dry eye symptom scale score, corneal fluorescein staining (FL) score, tear rupture time (BUT) and Schirmer I test (SIt) were compared in three groups; The levels of interleukin-6 (IL-6) and interleukin-8 (IL-8) in aqueous humor were compared among the three groups before and 7 days after operation.Results:⑴ The levels of IL-6 and IL-8 in aqueous humor of the three groups were significantly lower than those before operation, especially in group A ( P<0.05), but there was no significant difference in the levels of IL-6 and IL-8 in aqueous humor of group B and C ( P>0.05); ⑵ The scores of dry eye symptoms in group B were significantly higher than those in group A at 1 and 7 days after operation ( P<0.05); The scores of dry eye symptoms in group C were significantly higher than those in group A and B at 1, 7 and 30 days after operation ( P<0.05); The dry eye symptom score in group A and B decreased to the preoperative level 30 days after operation ( P>0.05), and that in group C decreased to the preoperative level 90 days after operation ( P>0.05); ⑶ The postoperative 1, 7 and 30 d BUT in group A and C were significantly higher than those in group B ( P<0.05), and the level of SIt was significantly lower than that in group B ( P<0.05); At 1 and 7 days after operation, SIt in group A was significantly lower than that in group C ( P<0.05); the FLS score in group A and C was significantly lower than that in group B at 1 and 7 days after operation ( P<0.05). Conclusions:The incision of corneoscleral margin has little effect on tear film stability and ocular surface function of cataract patients with type 2 diabetes mellitus treated by phacoemulsification, which is worthy of clinical recommendation.

Objective To investigate the role of capsaicin in regulating permeation of P-gp substrate rhodamine 123 (R123) across the jejunum, ileum and colon membranes of rats. Methods The permeability of R123 or fluorescein sodium (CF) across the jejunum, ileum and colon membranes of male SD rats was evaluated using a Ussing chamber. The concentration of R123 or CF in the receptor was determined using fluorospectrophotometry to calculate the apparent permeability coefficient (Papp). Results Compared with the blank control group, capsaicin increased the permeability of R123 across jejunal membranes in the mucosal-to-serosal (M-S) direction and decreased its permeability in the serosal-to-mucosal (S-M) direction, but produced no obvious effect on R123 transport across the ileum or colon membranes. Capsaicin caused a regional increase in the permeability of CF across the jejunal membranes compared with the control group, but CF transport across the ileum and colon membranes was not affected. Conclusion Capsaicin can affect the transport of R123 and CF across rat jejunal membranes, and this effect is shows an obvious intestine segment-related difference probably because of the different distribution of P-gp or tight junction in the intestines. This finding suggests that capsaicin is a weak P-gp inhibitor and an improver of mucous membrane channels.

Objective To investigate the role of capsaicin in regulating permeation of P-gp substrate rhodamine 123 (R123) across the jejunum, ileum and colon membranes of rats. Methods The permeability of R123 or fluorescein sodium (CF) across the jejunum, ileum and colon membranes of male SD rats was evaluated using a Ussing chamber. The concentration of R123 or CF in the receptor was determined using fluorospectrophotometry to calculate the apparent permeability coefficient (Papp). Results Compared with the blank control group, capsaicin increased the permeability of R123 across jejunal membranes in the mucosal-to-serosal (M-S) direction and decreased its permeability in the serosal-to-mucosal (S-M) direction, but produced no obvious effect on R123 transport across the ileum or colon membranes. Capsaicin caused a regional increase in the permeability of CF across the jejunal membranes compared with the control group, but CF transport across the ileum and colon membranes was not affected. Conclusion Capsaicin can affect the transport of R123 and CF across rat jejunal membranes, and this effect is shows an obvious intestine segment-related difference probably because of the different distribution of P-gp or tight junction in the intestines. This finding suggests that capsaicin is a weak P-gp inhibitor and an improver of mucous membrane channels.